Anatomical And Functional Correlates Of Cognitive Deficit In Multiple Sclerosis
Pozzilli C, Gasperini C, Anzini A, Grasso MG, Ristori G, Fieschi C
J Neurol Sci 1993 Apr;115 Suppl:S55-8
Univ of Rome La Sapienza, Dept of Neurological Science, Rome, Italy
PMID# 8340794; UI# 93340687
This brief article reviews the present state of knowledge concerning the relationship between structural and functional Cerebral abnormalities and the Cognitive deficits associated with Multiple Sclerosis.
Currently available NeuroImaging techniques have substantially contributed to a better understanding of the latter, suggesting that Cortical-SubCortical disconnection is the most likely cause of the Cognitive disturbance.
Longitudinal studies are needed to determine the natural history of the Cognitive deficit and its relationship to the Cerebral changes detected by NeuroImaging techniques.
NeuroPsychological Performance In Patients With Mild Multiple Sclerosis
Klonoff H, Clark C, Oger J, Paty D, Li D
J Nerv Ment Dis 1991 Mar;179(3):127-31
Univ of British Columbia, Dept of Psychiatry, Vancouver, Canada
PMID# 1997658; UI# 91147936
Although changes in Cognitive function in patients with Multiple Sclerosis (MS) have been reported, these changes have been traditionally associated with the later stages of the disease.
In the current study, a comprehensive NeuroPsychological battery was administered to MS patients (N = 86) in whom the disease progression was relatively mild and in remission and a demographically well-matched control group (N = 46).
Besides the expected differences in tests of Motor Function, the two groups also differed on a number of Cognitive tests with no motor demands.
The two Cognitive functions that appear impaired were Learning and Memory.
Given that similar deficits have been found in MS patients with more severe symptoms, it is argued that changes in Cognitive function can occur in the mild stages of the disease.
Anterior Corpus Callosum Atrophy And Verbal Fluency In Multiple Sclerosis
Pozzilli C, Bastianello S, Padovani A, Passafiume D, Millefiorini E, Bozzao L, Fieschi C
Cortex. 1991 Sep;27(3):441-5
University of Rome La Sapienza, Department of Neurological Science
To determine whether different portions of the Corpus Callosum (CC) are responsible for transferring the information of specific Cognitive modalities, eighteen females with Relapsing/Remitting Multiple Sclerosis (MS) were studied using NeuroPsychological procedures and Magnetic Resonance Imaging (MRI).
Measures of both Anterior and Posterior CC areas were obtained in patients with MS as well as in eighteen age and sex matched healthy controls.
MRI scans were additionally analyzed for each patient in order to evaluate the extent of DeMyelinating lesions in both PeriVentricular and SubCortical areas.
Patients with MS exhibited a significant decrease in both the Anterior and Posterior CC areas compared with normal subjects.
The results of statistical analysis showed that, even when the effect of DeMyelinating lesions was taken into account within a regression equation, the Atrophy of Anterior CC area strongly affected the performance on Verbal Fluency Task.
These data emphasize the importance of the Anterior CC area for the InterHemispheric transfer of Cognitive information associated with Verbal Fluency.
Mathiesen HK, Jonsson A, Tscherning T, Hanson LG, Andresen J, Blinkenberg M, Paulson OB, Sorensen PS
Arch Neurol 2006 Apr;63(4):533-6
Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, DK-2650 Hvidovre, Denmark
Whole-Brain N-Acetyl Aspartate (NAA), a measure of Neuronal function, can be assessed by multislice Echo-Planar Spectroscopic Imaging.
To test the hypothesis that the global Brain NAA/creatine (Cr) ratio is a better predictor of Cognitive Dysfunction in Multiple Sclerosis than conventional Magnetic Resonance Imaging measures.
Design & Setting
Survey research-oriented hospitals.
Twenty patients, 16 women and 4 men (mean age, 36 years), with early Relapsing/Remitting Multiple Sclerosis (mean Expanded Disability Status Scale score, 2.5).
Main Outcome Measures
Correlation between the global NAA/Cr ratio and a Cognitive Dysfunction factor comprising 16 measures from an extensive NeuroPsychological test battery that best distinguished patients with Multiple Sclerosis from healthy control subjects.
A significant partial correlation between the global NAA/Cr ratio and the Cognitive Dysfunction factor was found (partial r = 0.62, P = .01).
And 9 Cognitively impaired patients had significantly lower global NAA/Cr ratios than 11 unimpaired patients (P = .04).
No significant correlations were found between the Cognitive Dysfunction factor and conventional Magnetic Resonance Imaging measures (ie, Brain Parenchymal Fraction and Lesion Volume).
Multislice Echo-Planar Spectroscopic Imaging provides global metabolic measures that distinguish between Cognitively Impaired and unimpaired patients with Multiple Sclerosis and correlate with a global Cognitive measure.
Standardization of the technique is needed, and larger-scale studies that include healthy controls are suggested.